Sleep Apnea Patient Treatment Flow Research (Global)


Cello Health Advantage was originally retained by the US operating group within a global pharmaceutical company to develop a backgrounder on sleep apnea (based on secondary research), which also included interviews with 5 US-based key thought leaders.

As a follow-up to the US project, the headquarters office retained Cello Health Advantage to better understand, through primary research, the target populations and the treatment algorithm(s) for sleep apnea in the US and 3 key EU countries (France, Germany, and the UK).

Functional areas at the client that would use this information included clinical research, product development, marketing, market research and, possibly, finance, manufacturing, and sales.


Cello Health Advantage used its proprietary Matrix Intelligence Process® to complete the assignment. For this project, the steps in the process included secondary research and both qualitative and quantitative primary research with several stakeholder groups:


Cello Health Advantage developed the recruiting scripts, screeners, prework, discussion guides, and Internet survey; conducted the qualitative research; contracted for programming and hosting of the quantitative research; analyzed the findings; and prepared the reports at each stage of the research.

Disease Profile

The US and European physicians were by and large in agreement on the general characteristics, risk factors, and symptoms of patients with obstructive sleep apnea (OSA).  Initial discussions on OSA may be initiated by the patient, spouse, or physician.

In all countries, patients are categorized as mild (5–15 events/h), moderate (15–30 events/h), and severe (>30 events/h). The diagnosis of obstructive sleep apnea (OSA) in the US heavily relies on polysomnography; in the EU countries, diagnosis heavily relies on the ambulatory, home-based diagnostic systems.

Treatment goals focus on symptom relief and improvements in complications and cardiovascular risk factors. In all countries, for patients with mild OSA, behavioral therapy (including weight loss and exercise) is always first-line therapy; few patients are prescribed continuous positive airway pressure (CPAP) therapy (as first- or second-line therapy). Based on further evaluations, patients may be offered dental or oral appliances or surgery.

For patients with moderate and severe OSA, CPAP is always prescribed as first-line therapy; behavioral therapy is a priority, as well.

In some cases where the patient is obese, bariatric surgery may be recommended.


The Report

The final presentations included the following elements:

Research (3/country):

  • KOLs (42 slides)
  • Focus group summary (252 slides)
  • Quantitative research (≈100 slides) findings and recommendations

CDs with copies of the thought leader interviews (blinded) and focus groups as well as copies of the market research tools were provided.



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